Visual Processing – Part 4 – Do Something
These last several days I’ve been on a treasure hunt of sorts. My bounty, which I’m still not fully convinced I’ve discovered, is the best way to lay out this post. I’ve been looking for a way to write it without writing it, to detail an undetailed method, to demonstrate my thoughts absent the actual demonstration, to present a non-specific method in a very specific manner. To be successful, this presentation cannot appear to be “one size fits all” or “cookie cutter” in any way. It is, after all, dictated by each patient.
So with that, here’s some basic guidelines I’ve constructed for working Visual Processing. Remember, these are simply global thoughts under which a framework is constructed as individual as each patient!
Know the Who – no matter how much emphasis is placed on this one, my effort will fall short. Knowing your patient, their history, their tendencies, their level of confidence, and their position of comfort with respect to solving problems is paramount. This is probably why many offices, mine included, don’t delve too deeply into visual perception until several weeks into a VT program. The perceptual testing will offer a snapshot of results, but truly, the value in face-to-face interaction is key.
Work Safe – The importance of the patient-therapist relationship has been written about ad nauseam. If you’ve gleaned nothing else, know working visual processing will be much more productive if the patient feels safe, positive about themselves, and as part of a team. Rarely, when working visual processing do I allow it to seem the the patient is the only one “doing the work. Instead, we’re working together towards a goal. An example of this may be as I deliberately duplicate a patient’s pattern of parquetry incorrectly, and then ask them to “help me fix it”. Not only does this keep them engaged in the problem solving, it also seems to remove any aspect of perceived competition or possible failure. All this is done in an effort to keep the environment safe for exploration.
What Just Happened? – my vision therapy is BIG on self-assessment. A question often heard in my sessions is “What Just Happened?”, and it’s asked in a somewhat playful tone. I tend to request self-assessment in this way because the question is very open-ended and allows for anything. There’s no inference, judgment, or suggestion of my opinion. I want to open the door completely, and allow a patient to walk through at their own pace, and when they are ready. If you know how to act, even badly, you can come at this from a position of “I missed something” and ask the patient to help you understand. Secondarily, this also offers a patient the opportunity to verbalize, which coincidentally (but not really), seems to be a challenging skill for many patients with visual challenges. Trying to describe what you see when you don’t trust it has to be tough.
How Did You Do It? – if you know nothing else about me, know my vision therapy is 100% about the process. I can’t be bothered with the outcome, or the answer, there’s enough people in the world concerned with that part. I want to know what the plan was, how it was initiated, was it maintained throughout, was there a need to deviate, and was the plan in place the entire time? Many times this takes coaching on the part of the therapist, but once a patient grasps it, they will begin using it in their everyday lives, and most importantly in the classroom.
Likes and Dislikes – this is the step where, for my money, the cream rises to the top in terms of Vision Therapists. We all will listen and use the information to assist in the future, but the really good therapists will redirect, poking holes in those self-effacing thoughts. For example, a patient may say they failed (or dislike their own effort) because they could not replicate my parquetry pattern. If you can turn that sentiment into a positive, you’re on to something. Maybe with something like “well, you have all the correct colors and shapes, so you’re like 90% of the way there. Let’s do the rest together.” Before you know it, their dislikes will lessen.
Redo’s and Part Two’s – this one is fairly straight forward, and follows immediately after the Likes and Dislikes portion, for me. I ask them “If you had it to do again, what parts would you keep and what would you change?” (full credit to Dr. Bob Sanet for that sentence as I’m certain I learned it from him, almost verbatim). And after you ask, shut up and listen.
When The Hour’s Up – for all this to work, the skill must transfer to real life. Some will happen subconsciously through improved reasoning and deduction, but much of it can be aided by conscious reinforcement. For instance, “you know these skills we’re working on can be used to help with spelling, math, or even finding your way home when you’re lost”. Vision Therapy doesn’t lose its value when the session is over.
Visual Processing is tough, as much for the Vision Therapist as the patient, and if you’re anything like me, you probably think you can always get better in this area. Well, we can. For me, this area is the drive behind always wanting to get better. But remember, short of telling a patient they’re wrong or intimating they’re stupid, there’s really no wrong way to work visual processing. The key has been, is currently, and will always be, finding the best path for your patient and exploring it as far as they will let you. And if that path takes you to a dead end, sit back, relax, and channel a little presidential wisdom…
Do something. If it works, do more of it. If it doesn’t, do something else. – Franklin D. Roosevelt